Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 16524 | TN |
N | 363LN0000X | Nurse Practitioner - Neonatal | 4473-33 | WI |
NPI | 1235419920 |
---|---|
Provider Name | Mrs. Kori Rae Hoffert |
First Address | Chattanooga, TN 37403-2724 |
Second Address | Chattanooga, TN 37412-3909 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2011 |
Last Update Date | 14/08/2013 |